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Original Research: Pulmonary Vascular Disease |

Effect of Balloon Pulmonary Angioplasty on Respiratory Function in Patients With Chronic Thromboembolic Pulmonary Hypertension

Mina Akizuki, PT; Naoki Serizawa, MD, PhD; Atsuko Ueno, MD, PhD; Taku Adachi, PT, MS; Nobuhisa Hagiwara, MD, PhD
Author and Funding Information

FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study.

aDepartment of Rehabilitation, Tokyo Women's Medical University, Tokyo, Japan

bDepartment of Cardiology, Tokyo Women's Medical University, Tokyo, Japan

cDepartment of Internal Medicine and Rehabilitation, Science Disability Science, Tohoku University Graduate School of Medicine, Sendai, Japan

CORRESPONDENCE TO: Mina Akizuki, PT, Department of Rehabilitation, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-0054, Japan


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2017;151(3):643-649. doi:10.1016/j.chest.2016.10.002
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Background  Balloon pulmonary angioplasty (BPA) in chronic thromboembolic pulmonary hypertension (CTEPH) improves hemodynamics and exercise capacity. However, its effect on respiratory function is unclear. Our objective was to investigate the effect of BPA on respiratory function.

Methods  We enrolled patients with inoperable CTEPH who underwent BPA primarily in lower lobe arteries (first series) and upper and middle lobe arteries (second series). We compared changes in hemodynamics and respiratory function between different BPA fields.

Results  Sixty-two BPA sessions were performed in 13 consecutive patients. Mean pulmonary arterial pressure and pulmonary vascular resistance significantly improved from 44 ± 8 to 23 ± 5 mm Hg and 818 ± 383 to 311 ± 117 dyne/s/cm−5. The percent predicted diffusion capacity of lung for carbon monoxide (Dlco) decreased after BPA in the lower lung field (from 60% ± 8% to 54% ± 8%) with no recovery. Percent Dlco increased after BPA in the upper middle lung field (from 53% ± 6% to 58% ± 6%) and continued to improve during the follow-up (from 58% ± 6% to 64% ± 11%). The ventilation/Co2 production (e/co2) slope significantly improved after BPA in the lower lung field (from 51 ± 13 to 41 ± 8) and continued to improve during the follow-up (from 41 ± 8 to 35 ± 7); however, the e/co2 slope remained unchanged after BPA in the upper/middle lung field. Changes in % Dlco and the e/co2 slope differed significantly between lower and upper/middle lung fields.

Conclusions  The effect of BPA on respiratory function in patients with CTEPH differed depending on the lung field.

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